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최재걸(Jae Gol Choe) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.1
Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes after therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy. (Korean J Nucl Med 2001;35:1-11)
Evidence - Based Medicine 에 대한 소개
최재걸(Jae Gol Choe) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.4
EBM is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the progriosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures. (Korean J Nucl Med 200135:224-230)
골육종의 도약전이 진단에서 골스캔의 보완검사로서의 FDG-PET/CT: 증례 보고
천기정,최재걸,채인정,이대희,송상헌,김묘종,박종훈,Cheon, Gi-Jeong,Choe, Jae-Gol,Chae, In-Jung,Lee, Dae-Hee,Song, Sang-Heon,Kim, Myo-Jong,Park, Jong-Hoon 대한근골격종양학회 2012 대한골관절종양학회지 Vol.18 No.1
골육종에서 드물게 발생하는 도약전이 병소는 불량한 예후 인자로서 중요한 연관성이 있기 때문에 골육종 환자의 광범위 절제술 시에 절제범위에 포함되어야 한다. 따라서 수술 전 검사에서 골육종의 골수 내 침범에 대한 정밀한 평가가 필수적이며, 골스캔 검사는 도약전이의 발견에 있어서는 높은 위음성률을 보일수 있으며 자기공명영상 검사는 종양이 위치한 골 전체를 촬영하지 않는 경우 임상적인 증거가 없으면 간과하기가 쉽다는 단점이 있다. 이에 저자들은 주 종양 부위만을 포함한 국소 자기공명영상 촬영과 골스캔에서 발견되지 않았으나 FDG-PET/CT에서 도약 전이가 진단된 대퇴 원위부의 골육종 증례에 대해 문헌 고찰과 함께 보고하고자 한다. Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
유동식 및 고형식을 이용한 동위원소 식도통과검사의 임상적 의의에 대한 연구
이민재(Min Jae Lee),최재걸(Jae Gol Choe),서원혁(Won Hyuck Suh),송치욱(Chi Wook Song),현진해(Jin Hai Hyun) 대한핵의학회 1995 핵의학 분자영상 Vol.29 No.1
N/A The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophalgeal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT〈24 sec, MRR〈9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT〈35 sec, MRR〈9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2% and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically shoewed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm(DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in tranit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.
식도 운동 질환에 있어서 동위원소 식도 통과 검사의 의의
이민재(Min Jae Lee),최재걸(Jae Gol Choe),송치욱(Chi Wook Song) 대한핵의학회 1993 핵의학 분자영상 Vol.27 No.2
N/A Esophageal motility was evaluated from the analysis of 10 consecutive swallows using liquid bolus containing 0.5 mCi of Tc-99m tin colloid. We have reviewed our experience of esophageal transit study in the 20 normal volunteers and 55 patients with dysphagia that was not related to mechanical obstruction. The purpose of this study is to measure the esophageal transit in normal subjects and in patients with various esophageal motility disorders. The overall sensitivity and specificity of radionuclide esophageal transit study in detecting esophageal motor abnormality were compared with manometric results as a gold standard, which were 80% and 100% respectively. Radionuclide transit study is a safe, rapid, noninvasive test and suitable as a screening test for esophageal motor disorders.
99mTc - DTPA 및 Gamma Scintillation Camera를 이용한 사구체 여과율의 측정
이민재(Min Jae Lee),최재걸(Jae Gol Choe),백세현(Sei Hyun Baik),서원혁(Won Hyuck Suh) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.1
N/A The radioisotopic measurement of glomerular filtration rate (GFR) has required analysis of serial blood or urine samples over several hours, and does not allow measurement of separate renal function unless separate catherterization of individual ureters is done. Gates described isotopic method for the measurement of global and unilateral GFR based on the determination by scintillation camera of the fraction of the injected dose of Tc-99m-diethylenetriaminepentaacetic acid (DTPA) present in the kidneys 2-3 minutes after its administration.We calculated GFR according to Gates' method in 58 adult patients with various levels of global renal function using Tc-99m DTPA and validated this technique by correlation with 24 hour creatinine clearance. A good correlation was observed between 24 hour creatinine clearance and GFR calculated by Gates' formula, with an r value of 0.91 (p〈0.01). We concluded that determination of GFR according to the Gates' formula allows good and reproducible prediction of GFR with great rapidity and simplicity rendering this technique suitable for clinical practice.